Illinois General Assembly - Full Text of HB0246
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Full Text of HB0246  102nd General Assembly

HB0246enr 102ND GENERAL ASSEMBLY

  
  
  

 


 
HB0246 EnrolledLRB102 10452 SPS 15780 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.21 as follows:
 
6    (5 ILCS 100/5-45.21 new)
7    Sec. 5-45.21. Emergency rulemaking; Department of
8Healthcare and Family Services. To provide for the expeditious
9and timely implementation of the changes made to Articles 5
10and 5B of the Illinois Public Aid Code by this amendatory Act
11of the 102nd General Assembly, emergency rules implementing
12the changes made to Articles 5 and 5B of the Illinois Public
13Aid Code by this amendatory Act of the 102nd General Assembly
14may be adopted in accordance with Section 5-45 by the
15Department of Healthcare and Family Services. The adoption of
16emergency rules authorized by Section 5-45 and this Section is
17deemed to be necessary for the public interest, safety, and
18welfare.
19    This Section is repealed on September 30, 2022.
 
20    Section 5. The Illinois Public Aid Code is amended by
21changing Sections 5-5.2, 5-5.8, 5B-2, 5B-4, 5B-5, 5B-8, and
225E-10 and by adding Section 5E-20 as follows:
 

 

 

HB0246 Enrolled- 2 -LRB102 10452 SPS 15780 b

1    (305 ILCS 5/5-5.2)  (from Ch. 23, par. 5-5.2)
2    Sec. 5-5.2. Payment.
3    (a) All nursing facilities that are grouped pursuant to
4Section 5-5.1 of this Act shall receive the same rate of
5payment for similar services.
6    (b) It shall be a matter of State policy that the Illinois
7Department shall utilize a uniform billing cycle throughout
8the State for the long-term care providers.
9    (c) (Blank). Notwithstanding any other provisions of this
10Code, the methodologies for reimbursement of nursing services
11as provided under this Article shall no longer be applicable
12for bills payable for nursing services rendered on or after a
13new reimbursement system based on the Resource Utilization
14Groups (RUGs) has been fully operationalized, which shall take
15effect for services provided on or after January 1, 2014.
16    (c-1) Notwithstanding any other provisions of this Code,
17the methodologies for reimbursement of nursing services as
18provided under this Article shall no longer be applicable for
19bills payable for nursing services rendered on or after a new
20reimbursement system based on the Patient Driven Payment Model
21(PDPM) has been fully operationalized, which shall take effect
22for services provided on or after the implementation of the
23PDPM reimbursement system begins. For the purposes of this
24amendatory Act of the 102nd General Assembly, the
25implementation date of the PDPM reimbursement system and all

 

 

HB0246 Enrolled- 3 -LRB102 10452 SPS 15780 b

1related provisions shall be July 1, 2022 if the following
2conditions are met: (i) the Centers for Medicare and Medicaid
3Services has approved corresponding changes in the
4reimbursement system and bed assessment; and (ii) the
5Department has filed rules to implement these changes no later
6than June 1, 2022. Failure of the Department to file rules to
7implement the changes provided in this amendatory Act of the
8102nd General Assembly no later than June 1, 2022 shall result
9in the implementation date being delayed to October 1, 2022.
10    (d) The new nursing services reimbursement methodology
11utilizing the Patient Driven Payment Model RUG-IV 48 grouper
12model, which shall be referred to as the PDPM RUGs
13reimbursement system, taking effect July 1, 2022, upon federal
14approval by the Centers for Medicare and Medicaid Services
15January 1, 2014, shall be based on the following:
16        (1) The methodology shall be resident-centered
17    resident-driven, facility-specific, cost-based, and based
18    on guidance from the Centers for Medicare and Medicaid
19    Services and cost-based.
20        (2) Costs shall be annually rebased and case mix index
21    quarterly updated. The nursing services methodology will
22    be assigned to the Medicaid enrolled residents on record
23    as of 30 days prior to the beginning of the rate period in
24    the Department's Medicaid Management Information System
25    (MMIS) as present on the last day of the second quarter
26    preceding the rate period based upon the Assessment

 

 

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1    Reference Date of the Minimum Data Set (MDS).
2        (3) Regional wage adjustors based on the Health
3    Service Areas (HSA) groupings and adjusters in effect on
4    April 30, 2012 shall be included, except no adjuster shall
5    be lower than 1.06 1.0.
6        (4) PDPM nursing case mix indices in effect on March
7    1, 2022 Case mix index shall be assigned to each resident
8    class at no less than 0.7858 of based on the Centers for
9    Medicare and Medicaid Services PDPM unadjusted case mix
10    values, in effect on March 1, 2022, staff time measurement
11    study in effect on July 1, 2013, utilizing an index
12    maximization approach.
13        (5) The pool of funds available for distribution by
14    case mix and the base facility rate shall be determined
15    using the formula contained in subsection (d-1).
16        (6) The Department shall establish a variable per diem
17    staffing add-on in accordance with the most recent
18    available federal staffing report, currently the Payroll
19    Based Journal, for the same period of time, and if
20    applicable adjusted for acuity using the same quarter's
21    MDS. The Department shall rely on Payroll Based Journals
22    provided to the Department of Public Health to make a
23    determination of non-submission. If the Department is
24    notified by a facility of missing or inaccurate Payroll
25    Based Journal data or an incorrect calculation of
26    staffing, the Department must make a correction as soon as

 

 

HB0246 Enrolled- 5 -LRB102 10452 SPS 15780 b

1    the error is verified for the applicable quarter.
2        Facilities with at least 70% of the staffing indicated
3    by the STRIVE study shall be paid a per diem add-on of $9,
4    increasing by equivalent steps for each whole percentage
5    point until the facilities reach a per diem of $14.88.
6    Facilities with at least 80% of the staffing indicated by
7    the STRIVE study shall be paid a per diem add-on of $14.88,
8    increasing by equivalent steps for each whole percentage
9    point until the facilities reach a per diem add-on of
10    $23.80. Facilities with at least 92% of the staffing
11    indicated by the STRIVE study shall be paid a per diem
12    add-on of $23.80, increasing by equivalent steps for each
13    whole percentage point until the facilities reach a per
14    diem add-on of $29.75. Facilities with at least 100% of
15    the staffing indicated by the STRIVE study shall be paid a
16    per diem add-on of $29.75, increasing by equivalent steps
17    for each whole percentage point until the facilities reach
18    a per diem add-on of $35.70. Facilities with at least 110%
19    of the staffing indicated by the STRIVE study shall be
20    paid a per diem add-on of $35.70, increasing by equivalent
21    steps for each whole percentage point until the facilities
22    reach a per diem add-on of $38.68. Facilities with at
23    least 125% or higher of the staffing indicated by the
24    STRIVE study shall be paid a per diem add-on of $38.68.
25    Beginning April 1, 2023, no nursing facility's variable
26    staffing per diem add-on shall be reduced by more than 5%

 

 

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1    in 2 consecutive quarters. For the quarters beginning July
2    1, 2022 and October 1, 2022, no facility's variable per
3    diem staffing add-on shall be calculated at a rate lower
4    than 85% of the staffing indicated by the STRIVE study. No
5    facility below 70% of the staffing indicated by the STRIVE
6    study shall receive a variable per diem staffing add-on
7    after December 31, 2022.
8        (7) For dates of services beginning July 1, 2022, the
9    PDPM nursing component per diem for each nursing facility
10    shall be the product of the facility's (i) statewide PDPM
11    nursing base per diem rate, $92.25, adjusted for the
12    facility average PDPM case mix index calculated quarterly
13    and (ii) the regional wage adjuster, and then add the
14    Medicaid access adjustment as defined in (e-3) of this
15    Section. Transition rates for services provided between
16    July 1, 2022 and October 1, 2023 shall be the greater of
17    the PDPM nursing component per diem or:
18            (A) for the quarter beginning July 1, 2022, the
19        RUG-IV nursing component per diem;
20            (B) for the quarter beginning October 1, 2022, the
21        sum of the RUG-IV nursing component per diem
22        multiplied by 0.80 and the PDPM nursing component per
23        diem multiplied by 0.20;
24            (C) for the quarter beginning January 1, 2023, the
25        sum of the RUG-IV nursing component per diem
26        multiplied by 0.60 and the PDPM nursing component per

 

 

HB0246 Enrolled- 7 -LRB102 10452 SPS 15780 b

1        diem multiplied by 0.40;
2            (D) for the quarter beginning April 1, 2023, the
3        sum of the RUG-IV nursing component per diem
4        multiplied by 0.40 and the PDPM nursing component per
5        diem multiplied by 0.60;
6            (E) for the quarter beginning July 1, 2023, the
7        sum of the RUG-IV nursing component per diem
8        multiplied by 0.20 and the PDPM nursing component per
9        diem multiplied by 0.80; or
10            (F) for the quarter beginning October 1, 2023 and
11        each subsequent quarter, the transition rate shall end
12        and a nursing facility shall be paid 100% of the PDPM
13        nursing component per diem.
14    (d-1) Calculation of base year Statewide RUG-IV nursing
15base per diem rate.
16    (1) Base rate spending pool shall be:
17        (A) The base year resident days which are calculated
18    by multiplying the number of Medicaid residents in each
19    nursing home as indicated in the MDS data defined in
20    paragraph (4) by 365.
21        (B) Each facility's nursing component per diem in
22    effect on July 1, 2012 shall be multiplied by subsection
23    (A).
24            (C) Thirteen million is added to the product of
25        subparagraph (A) and subparagraph (B) to adjust for
26        the exclusion of nursing homes defined in paragraph

 

 

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1        (5).
2        (2) For each nursing home with Medicaid residents as
3    indicated by the MDS data defined in paragraph (4),
4    weighted days adjusted for case mix and regional wage
5    adjustment shall be calculated. For each home this
6    calculation is the product of:
7            (A) Base year resident days as calculated in
8        subparagraph (A) of paragraph (1).
9            (B) The nursing home's regional wage adjustor
10        based on the Health Service Areas (HSA) groupings and
11        adjustors in effect on April 30, 2012.
12            (C) Facility weighted case mix which is the number
13        of Medicaid residents as indicated by the MDS data
14        defined in paragraph (4) multiplied by the associated
15        case weight for the RUG-IV 48 grouper model using
16        standard RUG-IV procedures for index maximization.
17            (D) The sum of the products calculated for each
18        nursing home in subparagraphs (A) through (C) above
19        shall be the base year case mix, rate adjusted
20        weighted days.
21        (3) The Statewide RUG-IV nursing base per diem rate:
22            (A) on January 1, 2014 shall be the quotient of the
23        paragraph (1) divided by the sum calculated under
24        subparagraph (D) of paragraph (2); and
25            (B) on and after July 1, 2014 and until July 1,
26        2022, shall be the amount calculated under

 

 

HB0246 Enrolled- 9 -LRB102 10452 SPS 15780 b

1        subparagraph (A) of this paragraph (3) plus $1.76; and
2        .
3            (C) beginning July 1, 2022 and thereafter, $7
4        shall be added to the amount calculated under
5        subparagraph (B) of this paragraph (3) of this
6        Section.
7        (4) Minimum Data Set (MDS) comprehensive assessments
8    for Medicaid residents on the last day of the quarter used
9    to establish the base rate.
10        (5) Nursing facilities designated as of July 1, 2012
11    by the Department as "Institutions for Mental Disease"
12    shall be excluded from all calculations under this
13    subsection. The data from these facilities shall not be
14    used in the computations described in paragraphs (1)
15    through (4) above to establish the base rate.
16    (e) Beginning July 1, 2014, the Department shall allocate
17funding in the amount up to $10,000,000 for per diem add-ons to
18the RUGS methodology for dates of service on and after July 1,
192014:
20        (1) $0.63 for each resident who scores in I4200
21    Alzheimer's Disease or I4800 non-Alzheimer's Dementia.
22        (2) $2.67 for each resident who scores either a "1" or
23    "2" in any items S1200A through S1200I and also scores in
24    RUG groups PA1, PA2, BA1, or BA2.
25    (e-1) (Blank).
26    (e-2) For dates of services beginning January 1, 2014 and

 

 

HB0246 Enrolled- 10 -LRB102 10452 SPS 15780 b

1ending September 30, 2023, the RUG-IV nursing component per
2diem for a nursing home shall be the product of the statewide
3RUG-IV nursing base per diem rate, the facility average case
4mix index, and the regional wage adjustor. Transition rates
5for services provided between January 1, 2014 and December 31,
62014 shall be as follows:
7        (1) The transition RUG-IV per diem nursing rate for
8    nursing homes whose rate calculated in this subsection
9    (e-2) is greater than the nursing component rate in effect
10    July 1, 2012 shall be paid the sum of:
11            (A) The nursing component rate in effect July 1,
12        2012; plus
13            (B) The difference of the RUG-IV nursing component
14        per diem calculated for the current quarter minus the
15        nursing component rate in effect July 1, 2012
16        multiplied by 0.88.
17        (2) The transition RUG-IV per diem nursing rate for
18    nursing homes whose rate calculated in this subsection
19    (e-2) is less than the nursing component rate in effect
20    July 1, 2012 shall be paid the sum of:
21            (A) The nursing component rate in effect July 1,
22        2012; plus
23            (B) The difference of the RUG-IV nursing component
24        per diem calculated for the current quarter minus the
25        nursing component rate in effect July 1, 2012
26        multiplied by 0.13.

 

 

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1    (e-3) A Medicaid Access Adjustment of $4 adjusted for the
2facility average PDPM case mix index calculated quarterly
3shall be added to the statewide PDPM nursing per diem for all
4facilities with annual Medicaid bed days of at least 70% of all
5occupied bed days adjusted quarterly. For each new calendar
6year and for the 6-month period beginning July 1, 2022, the
7percentage of a facility's occupied bed days comprised of
8Medicaid bed days shall be determined by the Department
9quarterly. This subsection shall be inoperative on and after
10January 1, 2028.
11    (f) (Blank). Notwithstanding any other provision of this
12Code, on and after July 1, 2012, reimbursement rates
13associated with the nursing or support components of the
14current nursing facility rate methodology shall not increase
15beyond the level effective May 1, 2011 until a new
16reimbursement system based on the RUGs IV 48 grouper model has
17been fully operationalized.
18    (g) Notwithstanding any other provision of this Code, on
19and after July 1, 2012, for facilities not designated by the
20Department of Healthcare and Family Services as "Institutions
21for Mental Disease", rates effective May 1, 2011 shall be
22adjusted as follows:
23        (1) (Blank); Individual nursing rates for residents
24    classified in RUG IV groups PA1, PA2, BA1, and BA2 during
25    the quarter ending March 31, 2012 shall be reduced by 10%;
26        (2) (Blank); Individual nursing rates for residents

 

 

HB0246 Enrolled- 12 -LRB102 10452 SPS 15780 b

1    classified in all other RUG IV groups shall be reduced by
2    1.0%;
3        (3) Facility rates for the capital and support
4    components shall be reduced by 1.7%.
5    (h) Notwithstanding any other provision of this Code, on
6and after July 1, 2012, nursing facilities designated by the
7Department of Healthcare and Family Services as "Institutions
8for Mental Disease" and "Institutions for Mental Disease" that
9are facilities licensed under the Specialized Mental Health
10Rehabilitation Act of 2013 shall have the nursing,
11socio-developmental, capital, and support components of their
12reimbursement rate effective May 1, 2011 reduced in total by
132.7%.
14    (i) On and after July 1, 2014, the reimbursement rates for
15the support component of the nursing facility rate for
16facilities licensed under the Nursing Home Care Act as skilled
17or intermediate care facilities shall be the rate in effect on
18June 30, 2014 increased by 8.17%.
19    (j) Notwithstanding any other provision of law, subject to
20federal approval, effective July 1, 2019, sufficient funds
21shall be allocated for changes to rates for facilities
22licensed under the Nursing Home Care Act as skilled nursing
23facilities or intermediate care facilities for dates of
24services on and after July 1, 2019: (i) to establish, through
25June 30, 2022 a per diem add-on to the direct care per diem
26rate not to exceed $70,000,000 annually in the aggregate

 

 

HB0246 Enrolled- 13 -LRB102 10452 SPS 15780 b

1taking into account federal matching funds for the purpose of
2addressing the facility's unique staffing needs, adjusted
3quarterly and distributed by a weighted formula based on
4Medicaid bed days on the last day of the second quarter
5preceding the quarter for which the rate is being adjusted.
6Beginning July 1, 2022, the annual $70,000,000 described in
7the preceding sentence shall be dedicated to the variable per
8diem add-on for staffing under paragraph (6) of subsection
9(d); and (ii) in an amount not to exceed $170,000,000 annually
10in the aggregate taking into account federal matching funds to
11permit the support component of the nursing facility rate to
12be updated as follows:
13        (1) 80%, or $136,000,000, of the funds shall be used
14    to update each facility's rate in effect on June 30, 2019
15    using the most recent cost reports on file, which have had
16    a limited review conducted by the Department of Healthcare
17    and Family Services and will not hold up enacting the rate
18    increase, with the Department of Healthcare and Family
19    Services and taking into account subsection (i).
20        (2) After completing the calculation in paragraph (1),
21    any facility whose rate is less than the rate in effect on
22    June 30, 2019 shall have its rate restored to the rate in
23    effect on June 30, 2019 from the 20% of the funds set
24    aside.
25        (3) The remainder of the 20%, or $34,000,000, shall be
26    used to increase each facility's rate by an equal

 

 

HB0246 Enrolled- 14 -LRB102 10452 SPS 15780 b

1    percentage.
2    To implement item (i) in this subsection, facilities shall
3file quarterly reports documenting compliance with its
4annually approved staffing plan, which shall permit compliance
5with Section 3-202.05 of the Nursing Home Care Act. A facility
6that fails to meet the benchmarks and dates contained in the
7plan may have its add-on adjusted in the quarter following the
8quarterly review. Nothing in this Section shall limit the
9ability of the facility to appeal a ruling of non-compliance
10and a subsequent reduction to the add-on. Funds adjusted for
11noncompliance shall be maintained in the Long-Term Care
12Provider Fund and accounted for separately. At the end of each
13fiscal year, these funds shall be made available to facilities
14for special staffing projects.
15    In order to provide for the expeditious and timely
16implementation of the provisions of Public Act 101-10,
17emergency rules to implement any provision of Public Act
18101-10 may be adopted in accordance with this subsection by
19the agency charged with administering that provision or
20initiative. The agency shall simultaneously file emergency
21rules and permanent rules to ensure that there is no
22interruption in administrative guidance. The 150-day
23limitation of the effective period of emergency rules does not
24apply to rules adopted under this subsection, and the
25effective period may continue through June 30, 2021. The
2624-month limitation on the adoption of emergency rules does

 

 

HB0246 Enrolled- 15 -LRB102 10452 SPS 15780 b

1not apply to rules adopted under this subsection. The adoption
2of emergency rules authorized by this subsection is deemed to
3be necessary for the public interest, safety, and welfare.
4    (k) During the first quarter of State Fiscal Year 2020,
5the Department of Healthcare of Family Services must convene a
6technical advisory group consisting of members of all trade
7associations representing Illinois skilled nursing providers
8to discuss changes necessary with federal implementation of
9Medicare's Patient-Driven Payment Model. Implementation of
10Medicare's Patient-Driven Payment Model shall, by September 1,
112020, end the collection of the MDS data that is necessary to
12maintain the current RUG-IV Medicaid payment methodology. The
13technical advisory group must consider a revised reimbursement
14methodology that takes into account transparency,
15accountability, actual staffing as reported under the
16federally required Payroll Based Journal system, changes to
17the minimum wage, adequacy in coverage of the cost of care, and
18a quality component that rewards quality improvements.
19    (l) The Department shall establish per diem add-on
20payments to improve the quality of care delivered by
21facilities, including:
22        (1) Incentive payments determined by facility
23    performance on specified quality measures in an initial
24    amount of $70,000,000. Nothing in this subsection shall be
25    construed to limit the quality of care payments in the
26    aggregate statewide to $70,000,000, and, if quality of

 

 

HB0246 Enrolled- 16 -LRB102 10452 SPS 15780 b

1    care has improved across nursing facilities, the
2    Department shall adjust those add-on payments accordingly.
3    The quality payment methodology described in this
4    subsection must be used for at least State Fiscal Year
5    2023. Beginning with the quarter starting July 1, 2023,
6    the Department may add, remove, or change quality metrics
7    and make associated changes to the quality payment
8    methodology as outlined in subparagraph (E). Facilities
9    designated by the Centers for Medicare and Medicaid
10    Services as a special focus facility or a hospital-based
11    nursing home do not qualify for quality payments.
12            (A) Each quality pool must be distributed by
13        assigning a quality weighted score for each nursing
14        home which is calculated by multiplying the nursing
15        home's quality base period Medicaid days by the
16        nursing home's star rating weight in that period.
17            (B) Star rating weights are assigned based on the
18        nursing home's star rating for the LTS quality star
19        rating. As used in this subparagraph, "LTS quality
20        star rating" means the long-term stay quality rating
21        for each nursing facility, as assigned by the Centers
22        for Medicare and Medicaid Services under the Five-Star
23        Quality Rating System. The rating is a number ranging
24        from 0 (lowest) to 5 (highest).
25                (i) Zero-star or one-star rating has a weight
26            of 0.

 

 

HB0246 Enrolled- 17 -LRB102 10452 SPS 15780 b

1                (ii) Two-star rating has a weight of 0.75.
2                (iii) Three-star rating has a weight of 1.5.
3                (iv) Four-star rating has a weight of 2.5.
4                (v) Five-star rating has a weight of 3.5.
5            (C) Each nursing home's quality weight score is
6        divided by the sum of all quality weight scores for
7        qualifying nursing homes to determine the proportion
8        of the quality pool to be paid to the nursing home.
9            (D) The quality pool is no less than $70,000,000
10        annually or $17,500,000 per quarter. The Department
11        shall publish on its website the estimated payments
12        and the associated weights for each facility 45 days
13        prior to when the initial payments for the quarter are
14        to be paid. The Department shall assign each facility
15        the most recent and applicable quarter's STAR value
16        unless the facility notifies the Department within 15
17        days of an issue and the facility provides reasonable
18        evidence demonstrating its timely compliance with
19        federal data submission requirements for the quarter
20        of record. If such evidence cannot be provided to the
21        Department, the STAR rating assigned to the facility
22        shall be reduced by one from the prior quarter.
23            (E) The Department shall review quality metrics
24        used for payment of the quality pool and make
25        recommendations for any associated changes to the
26        methodology for distributing quality pool payments in

 

 

HB0246 Enrolled- 18 -LRB102 10452 SPS 15780 b

1        consultation with associations representing long-term
2        care providers, consumer advocates, organizations
3        representing workers of long-term care facilities, and
4        payors. The Department may establish, by rule, changes
5        to the methodology for distributing quality pool
6        payments.
7            (F) The Department shall disburse quality pool
8        payments from the Long-Term Care Provider Fund on a
9        monthly basis in amounts proportional to the total
10        quality pool payment determined for the quarter.
11            (G) The Department shall publish any changes in
12        the methodology for distributing quality pool payments
13        prior to the beginning of the measurement period or
14        quality base period for any metric added to the
15        distribution's methodology.
16        (2) Payments based on CNA tenure, promotion, and CNA
17    training for the purpose of increasing CNA compensation.
18    It is the intent of this subsection that payments made in
19    accordance with this paragraph be directly incorporated
20    into increased compensation for CNAs. As used in this
21    paragraph, "CNA" means a certified nursing assistant as
22    that term is described in Section 3-206 of the Nursing
23    Home Care Act, Section 3-206 of the ID/DD Community Care
24    Act, and Section 3-206 of the MC/DD Act. The Department
25    shall establish, by rule, payments to nursing facilities
26    equal to Medicaid's share of the tenure wage increments

 

 

HB0246 Enrolled- 19 -LRB102 10452 SPS 15780 b

1    specified in this paragraph for all reported CNA employee
2    hours compensated according to a posted schedule
3    consisting of increments at least as large as those
4    specified in this paragraph. The increments are as
5    follows: an additional $1.50 per hour for CNAs with at
6    least one and less than 2 years' experience plus another
7    $1 per hour for each additional year of experience up to a
8    maximum of $6.50 for CNAs with at least 6 years of
9    experience. For purposes of this paragraph, Medicaid's
10    share shall be the ratio determined by paid Medicaid bed
11    days divided by total bed days for the applicable time
12    period used in the calculation. In addition, and additive
13    to any tenure increments paid as specified in this
14    paragraph, the Department shall establish, by rule,
15    payments supporting Medicaid's share of the
16    promotion-based wage increments for CNA employee hours
17    compensated for that promotion with at least a $1.50
18    hourly increase. Medicaid's share shall be established as
19    it is for the tenure increments described in this
20    paragraph. Qualifying promotions shall be defined by the
21    Department in rules for an expected 10-15% subset of CNAs
22    assigned intermediate, specialized, or added roles such as
23    CNA trainers, CNA scheduling "captains", and CNA
24    specialists for resident conditions like dementia or
25    memory care or behavioral health.
26    (m) The Department shall work with nursing facility

 

 

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1industry representatives to design policies and procedures to
2permit facilities to address the integrity of data from
3federal reporting sites used by the Department in setting
4facility rates.
5(Source: P.A. 101-10, eff. 6-5-19; 101-348, eff. 8-9-19;
6102-77, eff. 7-9-21; 102-558, eff. 8-20-21.)
 
7    (305 ILCS 5/5-5.8)  (from Ch. 23, par. 5-5.8)
8    Sec. 5-5.8. Report on nursing home reimbursement. The
9Illinois Department shall report annually to the General
10Assembly, no later than the first Monday in April of 1982, and
11each year thereafter, in regard to:
12        (a) the rate structure used by the Illinois Department
13    to reimburse nursing facilities;
14        (b) changes in the rate structure for reimbursing
15    nursing facilities;
16        (c) the administrative and program costs of
17    reimbursing nursing facilities;
18        (d) the availability of beds in nursing facilities for
19    public aid recipients; and
20        (e) the number of closings of nursing facilities, and
21    the reasons for those closings; and .
22        (f) for years beginning 2025 and thereafter, drawing
23    on all available information that evaluates, to the extent
24    possible, nursing facility costs and revenue, including a
25    focus on the period of initial implementation of the

 

 

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1    payments and programs authorized in this Act.
2    The requirement for reporting to the General Assembly
3shall be satisfied by filing copies of the report as required
4by Section 3.1 of the General Assembly Organization Act, and
5filing such additional copies with the State Government Report
6Distribution Center for the General Assembly as is required
7under paragraph (t) of Section 7 of the State Library Act.
8(Source: P.A. 100-1148, eff. 12-10-18.)
 
9    (305 ILCS 5/5B-2)  (from Ch. 23, par. 5B-2)
10    Sec. 5B-2. Assessment; no local authorization to tax.
11    (a) For the privilege of engaging in the occupation of
12long-term care provider, beginning July 1, 2011 through June
1330, 2022, or upon federal approval by the Centers for Medicare
14and Medicaid Services of the long-term care provider
15assessment described in subsection (a-1), whichever is later,
16an assessment is imposed upon each long-term care provider in
17an amount equal to $6.07 times the number of occupied bed days
18due and payable each month. Notwithstanding any provision of
19any other Act to the contrary, this assessment shall be
20construed as a tax, but shall not be billed or passed on to any
21resident of a nursing home operated by the nursing home
22provider.
23    (a-1) For the privilege of engaging in the occupation of
24long-term care provider for each occupied non-Medicare bed
25day, beginning July 1, 2022, an assessment is imposed upon

 

 

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1each long-term care provider in an amount varying with the
2number of paid Medicaid resident days per annum in the
3facility with the following schedule of occupied bed tax
4amounts. This assessment is due and payable each month. The
5tax shall follow the schedule below and be rebased by the
6Department on an annual basis. The Department shall publish
7each facility's rebased tax rate according to the schedule in
8this Section 30 days prior to the beginning of the 6-month
9period beginning July 1, 2022 and thereafter 30 days prior to
10the beginning of each calendar year which shall incorporate
11the number of paid Medicaid days used to determine each
12facility's rebased tax rate.
13        (1) 0-5,000 paid Medicaid resident days per annum,
14    $10.67.
15        (2) 5,001-15,000 paid Medicaid resident days per
16    annum, $19.20.
17        (3) 15,001-35,000 paid Medicaid resident days per
18    annum, $22.40.
19        (4) 35,001-55,000 paid Medicaid resident days per
20    annum, $19.20.
21        (5) 55,001-65,000 paid Medicaid resident days per
22    annum, $13.86.
23        (6) 65,001+ paid Medicaid resident days per annum,
24    $10.67.
25        (7) Any non-profit nursing facilities without
26    Medicaid-certified beds, $7 per occupied bed day.

 

 

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1    Notwithstanding any provision of any other Act to the
2contrary, this assessment shall be construed as a tax but
3shall not be billed or passed on to any resident of a nursing
4home operated by the nursing home provider.
5    For each new calendar year and for the 6-month period
6beginning July 1, 2022, a facility's paid Medicaid resident
7days per annum shall be determined using the Department's
8Medicaid Management Information System to include Medicaid
9resident days for the year ending 9 months earlier.
10    (b) Nothing in this amendatory Act of 1992 shall be
11construed to authorize any home rule unit or other unit of
12local government to license for revenue or impose a tax or
13assessment upon long-term care providers or the occupation of
14long-term care provider, or a tax or assessment measured by
15the income or earnings or occupied bed days of a long-term care
16provider.
17    (c) The assessment imposed by this Section shall not be
18due and payable, however, until after the Department notifies
19the long-term care providers, in writing, that the payment
20methodologies to long-term care providers required under
21Section 5-5.2 5-5.4 of this Code have been approved by the
22Centers for Medicare and Medicaid Services of the U.S.
23Department of Health and Human Services and that the waivers
24under 42 CFR 433.68 for the assessment imposed by this
25Section, if necessary, have been granted by the Centers for
26Medicare and Medicaid Services of the U.S. Department of

 

 

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1Health and Human Services.
2(Source: P.A. 96-1530, eff. 2-16-11; 97-10, eff. 6-14-11;
397-584, eff. 8-26-11.)
 
4    (305 ILCS 5/5B-4)  (from Ch. 23, par. 5B-4)
5    Sec. 5B-4. Payment of assessment; penalty.
6    (a) The assessment imposed by Section 5B-2 shall be due
7and payable monthly, on the last State business day of the
8month for occupied bed days reported for the preceding third
9month prior to the month in which the tax is payable and due. A
10facility that has delayed payment due to the State's failure
11to reimburse for services rendered may request an extension on
12the due date for payment pursuant to subsection (b) and shall
13pay the assessment within 30 days of reimbursement by the
14Department. The Illinois Department may provide that county
15nursing homes directed and maintained pursuant to Section
165-1005 of the Counties Code may meet their assessment
17obligation by certifying to the Illinois Department that
18county expenditures have been obligated for the operation of
19the county nursing home in an amount at least equal to the
20amount of the assessment.
21    (a-5) The Illinois Department shall provide for an
22electronic submission process for each long-term care facility
23to report at a minimum the number of occupied bed days of the
24long-term care facility for the reporting period and other
25reasonable information the Illinois Department requires for

 

 

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1the administration of its responsibilities under this Code.
2Beginning July 1, 2013, a separate electronic submission shall
3be completed for each long-term care facility in this State
4operated by a long-term care provider. The Illinois Department
5shall provide a self-reporting notice of the assessment form
6that the long-term care facility completes for the required
7period and submits with its assessment payment to the Illinois
8Department. To the extent practicable, the Department shall
9coordinate the assessment reporting requirements with other
10reporting required of long-term care facilities.
11    (b) The Illinois Department is authorized to establish
12delayed payment schedules for long-term care providers that
13are unable to make assessment payments when due under this
14Section due to financial difficulties, as determined by the
15Illinois Department. The Illinois Department may not deny a
16request for delay of payment of the assessment imposed under
17this Article if the long-term care provider has not been paid
18by the State or the Medicaid managed care organization for
19services provided during the month on which the assessment is
20levied or the Medicaid managed care organization has not been
21paid by the State.
22    (c) If a long-term care provider fails to pay the full
23amount of an assessment payment when due (including any
24extensions granted under subsection (b)), there shall, unless
25waived by the Illinois Department for reasonable cause, be
26added to the assessment imposed by Section 5B-2 a penalty

 

 

HB0246 Enrolled- 26 -LRB102 10452 SPS 15780 b

1assessment equal to the lesser of (i) 5% of the amount of the
2assessment payment not paid on or before the due date plus 5%
3of the portion thereof remaining unpaid on the last day of each
4month thereafter or (ii) 100% of the assessment payment amount
5not paid on or before the due date. For purposes of this
6subsection, payments will be credited first to unpaid
7assessment payment amounts (rather than to penalty or
8interest), beginning with the most delinquent assessment
9payments. Payment cycles of longer than 60 days shall be one
10factor the Director takes into account in granting a waiver
11under this Section.
12    (c-5) If a long-term care facility fails to file its
13assessment bill with payment, there shall, unless waived by
14the Illinois Department for reasonable cause, be added to the
15assessment due a penalty assessment equal to 25% of the
16assessment due. After July 1, 2013, no penalty shall be
17assessed under this Section if the Illinois Department does
18not provide a process for the electronic submission of the
19information required by subsection (a-5).
20    (d) Nothing in this amendatory Act of 1993 shall be
21construed to prevent the Illinois Department from collecting
22all amounts due under this Article pursuant to an assessment
23imposed before the effective date of this amendatory Act of
241993.
25    (e) Nothing in this amendatory Act of the 96th General
26Assembly shall be construed to prevent the Illinois Department

 

 

HB0246 Enrolled- 27 -LRB102 10452 SPS 15780 b

1from collecting all amounts due under this Code pursuant to an
2assessment, tax, fee, or penalty imposed before the effective
3date of this amendatory Act of the 96th General Assembly.
4    (f) No installment of the assessment imposed by Section
55B-2 shall be due and payable until after the Department
6notifies the long-term care providers, in writing, that the
7payment methodologies to long-term care providers required
8under Section 5-5.2 5-5.4 of this Code have been approved by
9the Centers for Medicare and Medicaid Services of the U.S.
10Department of Health and Human Services and the waivers under
1142 CFR 433.68 for the assessment imposed by this Section, if
12necessary, have been granted by the Centers for Medicare and
13Medicaid Services of the U.S. Department of Health and Human
14Services. Upon notification to the Department of approval of
15the payment methodologies required under Section 5-5.2 5-5.4
16of this Code and the waivers granted under 42 CFR 433.68, all
17installments otherwise due under Section 5B-4 prior to the
18date of notification shall be due and payable to the
19Department upon written direction from the Department within
2090 days after issuance by the Comptroller of the payments
21required under Section 5-5.2 5-5.4 of this Code.
22(Source: P.A. 100-501, eff. 6-1-18; 101-649, eff. 7-7-20.)
 
23    (305 ILCS 5/5B-5)  (from Ch. 23, par. 5B-5)
24    Sec. 5B-5. Annual reporting; penalty; maintenance of
25records.

 

 

HB0246 Enrolled- 28 -LRB102 10452 SPS 15780 b

1    (a) After December 31 of each year, and on or before March
231 of the succeeding year, every long-term care provider
3subject to assessment under this Article shall file a report
4with the Illinois Department. The report shall be in a form and
5manner prescribed by the Illinois Department and shall state
6the revenue received by the long-term care provider, reported
7in such categories as may be required by the Illinois
8Department, and other reasonable information the Illinois
9Department requires for the administration of its
10responsibilities under this Code.
11    (b) If a long-term care provider operates or maintains
12more than one long-term care facility in this State, the
13provider may not file a single return covering all those
14long-term care facilities, but shall file a separate return
15for each long-term care facility and shall compute and pay the
16assessment for each long-term care facility separately.
17    (c) Notwithstanding any other provision in this Article,
18in the case of a person who ceases to operate or maintain a
19long-term care facility in respect of which the person is
20subject to assessment under this Article as a long-term care
21provider, the person shall file a final, amended return with
22the Illinois Department not more than 90 days after the
23cessation reflecting the adjustment and shall pay with the
24final return the assessment for the year as so adjusted (to the
25extent not previously paid). If a person fails to file a final
26amended return on a timely basis, there shall, unless waived

 

 

HB0246 Enrolled- 29 -LRB102 10452 SPS 15780 b

1by the Illinois Department for reasonable cause, be added to
2the assessment due a penalty assessment equal to 25% of the
3assessment due.
4    (d) Notwithstanding any other provision of this Article, a
5provider who commences operating or maintaining a long-term
6care facility that was under a prior ownership and remained
7licensed by the Department of Public Health shall notify the
8Illinois Department of any the change in ownership regardless
9of percentage, and shall be responsible to immediately pay any
10prior amounts owed by the facility. In addition, beginning
11January 1, 2023, all providers operating or maintaining a
12long-term care facility shall notify the Illinois Department
13of all individual owners and any individuals or organizations
14that are part of a limited liability company with ownership of
15that facility and the percentage ownership of each owner. This
16ownership reporting requirement does not include individual
17shareholders in a publicly held corporation. Submission of the
18information as part of the Department's cost reporting
19requirements shall satisfy this requirement.
20    (e) The Department shall develop a procedure for sharing
21with a potential buyer of a facility information regarding
22outstanding assessments and penalties owed by that facility.
23    (f) In the case of a long-term care provider existing as a
24corporation or legal entity other than an individual, the
25return filed by it shall be signed by its president,
26vice-president, secretary, or treasurer or by its properly

 

 

HB0246 Enrolled- 30 -LRB102 10452 SPS 15780 b

1authorized agent.
2    (g) If a long-term care provider fails to file its return
3on or before the due date of the return, there shall, unless
4waived by the Illinois Department for reasonable cause, be
5added to the assessment imposed by Section 5B-2 a penalty
6assessment equal to 25% of the assessment imposed for the
7year. After July 1, 2013, no penalty shall be assessed if the
8Illinois Department has not established a process for the
9electronic submission of information.
10    (h) Every long-term care provider subject to assessment
11under this Article shall keep records and books that will
12permit the determination of occupied bed days on a calendar
13year basis. All such books and records shall be kept in the
14English language and shall, at all times during business hours
15of the day, be subject to inspection by the Illinois
16Department or its duly authorized agents and employees.
17    (i) The Illinois Department shall establish a process for
18long-term care providers to electronically submit all
19information required by this Section no later than July 1,
202013.
21(Source: P.A. 96-1530, eff. 2-16-11; 97-403, eff. 1-1-12;
2297-813, eff. 7-13-12.)
 
23    (305 ILCS 5/5B-8)  (from Ch. 23, par. 5B-8)
24    Sec. 5B-8. Long-Term Care Provider Fund.
25    (a) There is created in the State Treasury the Long-Term

 

 

HB0246 Enrolled- 31 -LRB102 10452 SPS 15780 b

1Care Provider Fund. Interest earned by the Fund shall be
2credited to the Fund. The Fund shall not be used to replace any
3moneys appropriated to the Medicaid program by the General
4Assembly.
5    (b) The Fund is created for the purpose of receiving and
6disbursing moneys in accordance with this Article.
7Disbursements from the Fund shall be made only as follows:
8        (1) For payments to nursing facilities, including
9    county nursing facilities but excluding State-operated
10    facilities, under Title XIX of the Social Security Act and
11    Article V of this Code.
12        (1.5) For payments to managed care organizations as
13    defined in Section 5-30.1 of this Code.
14        (2) For the reimbursement of moneys collected by the
15    Illinois Department through error or mistake.
16        (3) For payment of administrative expenses incurred by
17    the Illinois Department or its agent in performing the
18    activities authorized by this Article.
19        (3.5) For reimbursement of expenses incurred by
20    long-term care facilities, and payment of administrative
21    expenses incurred by the Department of Public Health, in
22    relation to the conduct and analysis of background checks
23    for identified offenders under the Nursing Home Care Act.
24        (4) For payments of any amounts that are reimbursable
25    to the federal government for payments from this Fund that
26    are required to be paid by State warrant.

 

 

HB0246 Enrolled- 32 -LRB102 10452 SPS 15780 b

1        (5) For making transfers to the General Obligation
2    Bond Retirement and Interest Fund, as those transfers are
3    authorized in the proceedings authorizing debt under the
4    Short Term Borrowing Act, but transfers made under this
5    paragraph (5) shall not exceed the principal amount of
6    debt issued in anticipation of the receipt by the State of
7    moneys to be deposited into the Fund.
8        (6) For making transfers, at the direction of the
9    Director of the Governor's Office of Management and Budget
10    during each fiscal year beginning on or after July 1,
11    2011, to other State funds in an annual amount of
12    $20,000,000 of the tax collected pursuant to this Article
13    for the purpose of enforcement of nursing home standards,
14    support of the ombudsman program, and efforts to expand
15    home and community-based services. No transfer under this
16    paragraph shall occur until (i) the payment methodologies
17    created by Public Act 96-1530 under Section 5-5.4 of this
18    Code have been approved by the Centers for Medicare and
19    Medicaid Services of the U.S. Department of Health and
20    Human Services and (ii) the assessment imposed by Section
21    5B-2 of this Code is determined to be a permissible tax
22    under Title XIX of the Social Security Act.
23    Disbursements from the Fund, other than transfers made
24pursuant to paragraphs (5) and (6) of this subsection, shall
25be by warrants drawn by the State Comptroller upon receipt of
26vouchers duly executed and certified by the Illinois

 

 

HB0246 Enrolled- 33 -LRB102 10452 SPS 15780 b

1Department.
2    (c) The Fund shall consist of the following:
3        (1) All moneys collected or received by the Illinois
4    Department from the long-term care provider assessment
5    imposed by this Article.
6        (2) All federal matching funds received by the
7    Illinois Department as a result of expenditures made from
8    the Fund by the Illinois Department that are attributable
9    to moneys deposited in the Fund.
10        (3) Any interest or penalty levied in conjunction with
11    the administration of this Article.
12        (4) (Blank).
13        (5) All other monies received for the Fund from any
14    other source, including interest earned thereon.
15(Source: P.A. 96-1530, eff. 2-16-11; 97-584, eff. 8-26-11.)
 
16    (305 ILCS 5/5E-10)
17    Sec. 5E-10. Fee. Through June 30, 2022 or upon federal
18approval by the Centers for Medicare and Medicaid Services of
19the long-term care provider assessment described in subsection
20(a-1) of Section 5B-2 of this Code, whichever is later, every
21Every nursing home provider shall pay to the Illinois
22Department, on or before September 10, December 10, March 10,
23and June 10, a fee in the amount of $1.50 for each licensed
24nursing bed day for the calendar quarter in which the payment
25is due. This fee shall not be billed or passed on to any

 

 

HB0246 Enrolled- 34 -LRB102 10452 SPS 15780 b

1resident of a nursing home operated by the nursing home
2provider. All fees received by the Illinois Department under
3this Section shall be deposited into the Long-Term Care
4Provider Fund.
5(Source: P.A. 88-88; 89-21, eff. 7-1-95.)
 
6    (305 ILCS 5/5E-20 new)
7    Sec. 5E-20. Repealer. This Article 5E is repealed on July
81, 2024.
 
9    Section 99. Effective date. This Act takes effect upon
10becoming law.